| NPI | 1760052443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: 5811) |
| Additional Taxonomies | 133N00000X Nutritionist |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 175F00000X Naturopath | |
| 246ZE0500X Specialist/Technologist, Other, EEG (Licence: 5811) | |
| 293D00000X Physiological Laboratory | |
| 374K00000X Religious Nonmedical Practitioner | |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2021-06-25 |